NPI | 1275909566 |
---|---|
Entity Type | Organization |
Authorized Contact | THOMAS AQUINAS RASKAUSKAS President/CEO 203-275-0202 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization |
Enumeration Date | 2015-08-20 |
Last Update Date | 2015-08-20 |